Is it Time to Say Goodbye to our DSLR Cameras?

By Dr. Anthony M. Puntillo, DDS, MSD

When I first graduated from my orthodontic residency, now more than 23 years ago, a standard set of initial records included plaster models, facial and intraoral photographs taken with film, developed, then trimmed and placed into mounts and panoramic and lateral cephalometric radiographs taken with film and developed in darkrooms. The digitization of our society has made the process of gathering and storing this important diagnostic information much more efficient for most orthodontists. In fact, more than four years ago (November 2012) I wrote a Tech Blog article on digital retainers and the impressionless orthodontic practice. Since then the use of intraoral scanners and 3D printing in our profession has grown exponentially. It is now not hard to imagine a day in the near future when impressions will disappear completely from the practice of dentistry.  As I near the end of my 8 year term on the CTECH committee, I can’t help but wonder what is next.   Where else can we use technology to eliminate inefficient processes from our practices?

The most obvious next step for me is the elimination of intraoral photographs. All of those intraoral scanners, now used by most orthodontists, take multiple photographs of our patients’ teeth to create the 3D digital images. Several of these scanners can capture images in true, or close to true color. It can’t be long before we come to the realization that digital images taken with a good intraoral scanner are a better alternative to the standard set of 5-7 intraoral 2D photos we have been taking for decades. The 3D digital image is not only a better diagnostic record of the patient’s current dental state, it also is more versatile in that it can also be used to create and fabricate appliances (i.e. clear aligners, indirect bonding setups, retainers, etc.). If a good intraoral scan can consistently be completed in less than 10 minutes, aren’t we wasting our time and that of our patients’ taking 2D photos. I concede that we are all very accustomed to diagnosing our patients with these 2D photographic images. However, it was not that long ago when most thought that multiple radiographic exposures were necessary on the majority of our patients.   Now most of our patients are diagnosed with a single, quick radiograph taken on a CBCT machine and from that single exposure we derive a much higher level of diagnostic information.

To be honest, I am not yet ready to mothball our cameras. For starters, I still think that facial 2D photos are necessary. I know that there are 3D cameras available that will someday eliminate the need for our extraoral series of facial photos. However, for whatever reason (I believe primarily cost) these have not yet caught on. So for now we will still be taking a series of three 2D digital photos of our patients’ faces. Additionally, 2D intraoral pictures still play a significant role in our new patient consultations. We have not yet found the best way to display and share the captured 3D dental images (STL files) to educate our patients. I anticipate that this last hurdle will be overcome in 2017 and when that happens our DSLRs are going to see much less action and our IOSs are going to play an even larger role in our new patient process.

3 thoughts on “Is it Time to Say Goodbye to our DSLR Cameras?

  1. Great points. However, I would caution orthodontic residents, young orthodontists and those starting out in practice against taking this article as “proof” that CBCT and scanners are necessary to practice orthodontics since many cannot afford those things and don’t have the fee structure of patient flow to justify that cost. An old iPhone an some alginate or PVS still work great! Be conservative when you are starting out. The toys are awesome and will be the standard of care one day but they aren’t yet. CBCT and scanners are not owned by “most orthodontists” at this point in time and it will be a while still before that happens.
    If you can afford great tech, I’ll certainly admit it’s more fun and even better in some situations but if you go broke chasing the Joneses, none of that matters!

  2. A third method of intraoral scanning is being developed employing sound waves.
    It will be faster than the current procedures.
    It will be 3D.
    A dentist should be able to detect caries without X-Rays
    Taking a full mouth scan will take perhaps sixty seconds.

Leave a Reply

Your email address will not be published. Required fields are marked *

By submitting this form, you accept the Mollom privacy policy.